Toinea McGill
@toineamcgill
Provider and facility enrollment specialist delivering compliant onboarding that keeps providers credentialed and billable.
United StatesWhat I'm looking for
I’m a Provider and Facility Enrollment Specialist with 4+ years of healthcare administration experience supporting provider and facility enrollment, credentialing, compliance, provider onboarding, and regulatory readiness. I manage enrollment activities across commercial and government payers, keeping provider data integrity strong and reducing risk of reimbursement interruptions.
At ALLIANCE SPINE & PAIN CENTERS, I manage the full enrollment lifecycle for 80+ providers and 19 ambulatory surgical centers (ASCs) and ancillary facilities. I maintain and monitor facility enrollment requirements (including CLIA certifications, Medicare/Medicaid enrollment records, and payer participation), coordinate revalidations and ownership/location/group updates, and proactively submit applications before deadlines.
I’m hands-on with CAQH, PECOS, NPPES, and payer portal management, and I maintain credentialing documentation for items like provider licenses, board certifications, DEA registrations, malpractice certificates, and joint commission survey readiness. Before credentialing, I worked in benefits verification and patient coordination, which sharpened my payer communication, documentation discipline, and service mindset.
Experience
Work history, roles, and key accomplishments
Provider Enrollment Specialist I
Alliance Spine & Pain Centers
Apr 2025 - Present (1 year 2 months)
Managed full enrollment lifecycle for 80+ providers, 19 ASCs, and ancillary facilities across commercial and government payers, ensuring timely enrollment, revalidations, and uninterrupted reimbursement. Maintained provider data in CAQH, PECOS, and NPPES and supported CLIA, Medicare/Medicaid, and Joint Commission compliance through audits and payer outreach.
Provider Enrollment Specialist
Alliance Spine & Pain Centers
Mar 2023 - Apr 2025 (2 years 1 month)
Processed initial enrollments, revalidations, and demographic updates for commercial and government payers, supporting accurate provider maintenance. Tracked enrollment statuses, completed payer follow-ups, and collaborated on provider onboarding with credentialing documentation and payer roster submissions.
Patient Coordinator
Goals Plastic Surgery
Feb 2021 - Sep 2022 (1 year 7 months)
Scheduled in-person and virtual consultations for surgical patients and coordinated patient intake, documentation, and surgical preparation activities. Prepared contracts and consent forms while managing high-volume communications with a focus on confidentiality and service quality.
Assistant / Senior Aide
Luxury Living Recovery
Jan 2019 - Feb 2021 (2 years 1 month)
Coordinated care support services for post-operative clients and served as the primary point of contact for client and provider communications. Assisted with onboarding and training of new staff members while maintaining confidentiality and delivering exceptional client experiences.
Education
Degrees, certifications, and relevant coursework
Gupton Jones College of Funeral Service
Funeral Science
2014 - 2015
Studied Funeral Science at Gupton Jones College of Funeral Service from March 2014 to June 2015.
Booker T. Washington High School
College Preparatory Honors Program
2001 - 2006
Completed the College Preparatory Honors Program at Booker T. Washington High School from August 2001 to June 2006.
Tech stack
Software and tools used professionally
Availability
Location
United StatesAuthorized to work in
Job categories
Skills
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